Medical Billing and Telemedicine

Medical Billing and Telemedicine

Telemedicine refers to a category of services that are provided to a patient without any actual patient contact. Services are provided via a telephone, web portal or via email interactions between the patient and provider.

The Corona virus crisis has created billing requirement with telemedicine a significant issue. The guidelines for billing telemedicine are not only changing apace but also differ from payer to payer.  All the major private insurances pay telemedicine. Private insurance companies and Medicare are streamlining telemedicine policies virtually on a daily basis. Now Medicare allows telemedicine visits for new patients as well.

Simple pointers to consider when billing telemedicine:-

• Confirm that the patient’s insurance covers telemedicine. Always call and verify coverage with the patient’s insurance before their initial telemedicine visit
• Knowledge of the telemedicine guidelines for each payer. Rules and regulations differ from payer to payer and also area vice.
• Claims for covered telehealth services provided at the distant site need to be submitted using the applicable CPT or HCPCS code.
Documentation necessities for a telemedicine service are the similar as for face-to-face services. As telemedicine becomes more efficient and improves patient outcomes, more services are likely to be approved for reimbursement. In the present situation as more payers reimburse telehealth services, payment policies and criteria will be regularly amended, hence constant observation and updation is required on the telemedicine billing services.

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